股骨髁上骨折动力髁螺钉内固定方法的临床应用研究

目的：比较股骨动力髁螺钉治疗股骨远端骨折的效果。方法：取6副尸体股骨标本，制成股骨远端骨折（AO分类的A1型），采用股骨动力髁螺钉（DCS）、逆行交锁髓内钉、顺行交锁髓内钉三种内固定方法，进行实验应力分析，比较不同内固定方法的优劣。应用股骨股骨动力髁螺钉治疗28例患者。骨折按AO／ASIF分类：A15例、A26例、A317例。结果：在受同等载荷条件下，DCS固定方法最佳，而采用交锁髓内钉固定的股骨远端骨折刚度较差（P〈0．01）。采用股骨动力髁螺钉平均手术时间92min，平均出血量400ml，平均随访14个月，骨折愈合时间3～9月（平均4．7月），按NEER功能评定标准，优良27例（93％），可2例。结论：股骨动力髁螺钉可有效治疗股骨远端骨折，具有操作简便、直观、固定牢固、并发症少等优点。

Clinical Study of Fixing Supracondylar Fractures Using DCS

Objective:To determine the effectiveness of DCS for distal femur fracture.Methods:The distal femoral fractures were made on 6 fresh cadaver femurs(A1 of AO classification).The fractures have been fixed by using DCS,intramedullary nail,and retrograde intramedullary nail fixation.These three different internal fixation methods have been compared through experimental stress analysis.28 cases of distal femur fractures were treated,with DCS nail.The fractures was classified according(28 AO/ASIF(AO Type 5A1,,6A2,17A3).Results: Under the same load condition DCS method is the best,while for intramedullary nail,retrograde intramedullary nail method,The femoral condyle strength and origidity is worse(P<0.01).Average operation time was 92 m inutes and average estimated blood loss 400ml.With average 14 months follow-up and fracture united 3-9 months(means 4.7 months) after operation with DCS.The evaluation of the results by Neer's functional rating scale revealed good and excellent in 26 cases(93%) fair in two.Conclusions: DCS is an excellent alternative for the treatment of distal femur fracture.It has advantage of simple performance,solid fixation and less complication.